Under the guidelines adopted by the American College of Cardiology and the American Heart Association in 2017, nearly half of American adults have high blood pressure. Most of them take medication to treat it. However, many people don’t like the side effects of their anti-hypertensive medicine and end up wishing they had a better blood pressure pill.

Can You Find a Better Blood Pressure Pill?

Q. I have been taking atenolol to control my blood pressure for some years now. Perhaps as a result, I feel very foggy and tired.

When I mentioned this, my doctor suggested I change to Cozaar. I have read a number of patient reviews about the serious side effects of Cozaar and I am concerned. Is there any data about the relative safety of the two drugs?

Is Atenolol or Losartan Better?

A. You have asked an excellent question. Both atenolol and losartan (Cozaar) have been used for decades, so you might imagine that comparing their safety would be relatively simple. However, head-to-head trials, particularly those focusing on adverse effects, are not common.

Both drugs lower blood pressure, but atenolol is no longer considered a first-line treatment for high blood pressure (Cochrane Database of Systematic Reviews, Jan. 20, 2017).  That is primarily because it is not as effective in preventing stroke and coronary heart disease as other types of blood pressure medicine.

Comparing Side Effects of Atenolol and Losartan:

At least one study comparing the two drugs found that people had fewer side effects on losartan than on atenolol (Journal of Hypertension, Sep. 2002).  The most common side effects from atenolol include fatigue, dizziness, depression, slow heart rate, cold hands and feet and breathing difficulties. Losartan can also cause fatigue or weakness, dizziness, digestive distress and cough.

Learn More:

We recommend that you discuss your qualms further with your doctor. To help you prepare for that conversation, we are sending you our Guide to Blood Pressure Treatment, which discusses side effects of the main types of blood pressure medications. We hope it helps you identify a better blood pressure pill for your situation.

You may also wish to listen to our recent podcast on the guidelines and some possible ways to reduce blood pressure without drugs. It is Show 1134. In it, our guest experts discuss the new guidelines, the relaxation response and the power of sauna bathing.

Related People's Pharmacy Health Guide

Watch a brief welcome from Joe & Terry

Your browser doesn't support HTML5 video.